磺达肝癸钠和依诺肝素在75岁以上急性冠脉综合征患者中的应用  

Application of fondaparinux and enoxapar in the treatment of acute coronary syndrome in patients older than 75 years

作　　者：李百彦[1] 张萍[1] 

机构地区：[1]山东大学附属千佛山医院保健科,济南250014

出　　处：《中华现代护理杂志》2012年第19期2271-2273,共3页Chinese Journal of Modern Nursing

摘　　要：目的比较在75岁以上老年急性冠脉综合征（ACS）患者中应用磺达肝癸钠和依诺肝素的安全性。方法2009年12月至2011年12月期间，将75岁以上老年ACS患者127例随机分为成对照组（n=63）和观察组（n=64），两组患者均在常规应用ACS药物治疗且无应用抗凝药物禁忌情况下分别应用依诺肝素和磺达肝癸钠，对照组为依诺肝素组，0．75mg／kg皮下注射，每12小时1次，持续8d；观察组为磺达肝癸钠组，2．5mg皮下注射，每天1次，持续8d。比较两组患者严重出血（脑出血、腹膜腔出血、呕血、便血＋＋＋＋）及轻度出血（皮下瘀斑、牙龈出血、血尿、便血＋＋＋及以下）的发生率。结果观察组中发生严重出血者1例（1．56％），对照组中发生严重出血者9例（14．29％），两组严重出血率比较差异有统计学意义（χ^2=9．141，P=0．003）；观察组中发生轻度出血者7例（10．94％），对照组中发生轻度出血者20例（31．75％），两组轻度出血率比较差异有统计学意义（χ^2=5．266，P=0．017）。结论75岁以上老年ACS患者应用磺达肝癸钠的出血率低于应用依诺肝素，安全性更高。Objective To evaluate the incidence of bleeding events and nursing effects of fondaparinux and enoxapar in the treatment of acute coronary syndrome in patients 〉 75 years of old. Methods Between December 2009 and December 2011, A total of 127 patients 〉 75 years of old with acute coronary syndrome and no contraindications for anti-coagulants were randomly assigned to the control group （ enoxapar n = 63 ） and the observation group （fondaparinux n = 64）. The conventional treatment was added in both group, fondaparinux was added （2.5 mg daily subcutaneously for 8 days） in the observation group, and enoxaparin （0.75 mg/kg twice daily for 8 days ） was added in the control group and then we compared the incidence of bleeding events （including severe bleeding and minor bleeding events） between the two groups. Results The incidence of severe bleeding events in the observation group and control group was 1 （ 1. 56% ） and 9 （ 14. 29% ）, respectively, and the difference had reached statistical significance （χ^2 = 9. 141, P = 0. 003 ）. The incidence of minor bleeding in the observational group and control group were 7 （ 10.94% ） and 20（31.75% ） ,respectively, and has also reached statistical significance （ χ^2 = 5. 266, P = 0. 017 ）. Conclusions In the treatment of acute coronary syndrome patients 〉 75 years of old, fondaparinux has a lower incidence of bleeding events and thus it is safer than euoxapar.

关 键 词：护理 依诺肝素 磺达肝癸钠 急性冠脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]